So, just an update from my last bit on discontinuing my CPAP. I feel like I’m back to where I was before the CPAP started causing problems, and I’m also up to 30mg of nortriptyline and that’s feeling fine. I also heard back from the sleep clinic today and while the doctor still hasn’t had a chance to go over my sleep study (I guess she’s been out of the office for some reason) the clinician agreed that I should stay off CPAP for now if I’m feeling better without it.

It’s weird to see how one month in I felt like the CPAP was doing me a lot of good. I wonder what changed after that. It felt like it correlated to when I experienced a major push crash but at that point I still felt optimistic about it. But it was only a week later that I felt like I’d regressed to where I started, and I was thinking that the medication had lost effectiveness, not that it was CPAP causing trouble.

I mean, heck, even just two and a half weeks ago I felt like things were improving and crediting CPAP with it! I dunno, these last few months have been weird and hard to track and I feel like if I’d been maintaining my pain journal I’d have a better idea about what’s been going on.

Hopefully the sleep study wasn’t a complete waste of time and money and it tells me something useful, or maybe I can do another in-lab sleep study without the CPAP interfering with things and then maybe that will tell me something more useful. I have a sneaking suspicion that the in-home sleep study was invalidated by cats. Like, the way the in-home study worked was I stuck a microphone to my chest and they recorded audio of it overnight, and then just looked at the audio levels to see when I was snoring, but like, I don’t snore, but I do have cats that like to snuggle up with me and I move around and stuff so maybe I was having central apnea issues while cats where rubbing against my chest, and that looked like obstructive apnea.

I’ve used a couple of different apps to record overnight sound in my bedroom and the only audio spikes that happen are either my cats meowing or me making non-snoring noises (usually a quiet moan, often immediately after a huge fart). I can totally buy the moans coming after a central apnea event, but I am definitely not snoring.

The sleep clinicians kept on saying how the CPAP machine has “improved” my AHI, bringing it down from 17 to less than 1, but they only have a single data point to claim that it was 17, and of course my AHI would be less than 1 if I’m not falling asleep. It all feels like I’m caught up in other peoples' circular reasoning given a veneer of science.

And I gave CPAP a fair chance and I really wanted it to work but not being on CPAP is giving me way better sleep and is improving my symptoms overall.

Maybe a different mask would work better for me, but it seems more likely that a different therapy would be advised instead.

CPAP might work for a lot of people but it certainly isn’t a universal fix, and in my case it seems to have been making things worse. And I’ve gotten pretty tired of this whole “cult of CPAP” which insists that it is the one true path to sleep redemption.